Sánchez Zalabardo D, Millán Serrano J A, De Pablo Cárdenas A, Cuesta Alcalá J A
Servicio de Urología, Hospital Reina Sofía, Tudela, Navarra, España.
Actas Urol Esp. 2010 Feb;34(2):134-41.
Locally advanced renal tumors show a high progression rate after surgery. Surgical treatment of renal tumors has some unique characteristics related to involvement of the adrenal gland, vena cava, or regional lymph nodes.
To review the current treatment of locally advanced renal tumors.
A review is made of both the different drugs used and the different therapeutic possibilities in these tumors.
Systemic treatment with angiogenesis inhibitors may improve the natural history of these patients. Systemic treatment may be administered before surgery or as an adjuvant to surgical treatment. Early studies showed a decrease in tumor mass when treatment is administered before surgery, but no prospective randomized studies providing adequate evidence for recommending neoadjuvant treatment are available.
Availability of systemic treatment with angiogenesis inhibitors may open an important field in the treatment of these tumors in both the neoadjuvant setting and as adjuvants to surgery, but no sufficiently solid scientific evidence as to recommend their use is currently available. Randomized studies with sunitinib and sorafenib will probably suggest the adequate approach to be used when their final results are reported.
局部进展期肾肿瘤术后显示出较高的进展率。肾肿瘤的手术治疗具有一些与肾上腺、腔静脉或区域淋巴结受累相关的独特特征。
综述局部进展期肾肿瘤的当前治疗方法。
对这些肿瘤中使用的不同药物和不同治疗可能性进行综述。
使用血管生成抑制剂进行全身治疗可能改善这些患者的病程。全身治疗可在手术前进行或作为手术治疗的辅助治疗。早期研究表明，术前进行治疗时肿瘤体积会减小，但尚无提供充分证据推荐新辅助治疗的前瞻性随机研究。
血管生成抑制剂全身治疗的可用性可能在新辅助治疗和手术辅助治疗这两个方面为这些肿瘤的治疗开辟一个重要领域，但目前尚无足够确凿的科学证据推荐使用它们。当舒尼替尼和索拉非尼的最终结果报告出来时，随机研究可能会提示应采用的适当方法。
